NIHRANNUALREPORT2015/16

The National Institute for Health Research (NIHR) is funded through the Department of Health to improve the health and wealth of the nation through research. It is a large, multi-faceted and nationally distributed organisation. Together, NIHR people, facilities and systems represent the most integrated clinical research system in the world, driving research from bench to bedside for the benefit of patients and the economy.

Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research.

INTRODUCTION

2NIHR ANNUAL REPORT 2015/16

VISIONTo improve the health and wealth of the nation through research.

MISSIONTo provide a health research system in which the NHS supports outstanding

individuals working in world-class facilities, conducting leading-edge

research focused on the needs of patients and the public.

A IMS• Establish the NHS as an internationally recognised centre of research

excellence

• Attract, develop and retain the best research professionals to conduct

people-based research

• Commission research focused on improving health and social care

• Strengthen and streamline systems for research management and

governance

• Increase the opportunities for patients and the public to participate in,

and benefit from, research

• Promote and protect the interests of patients and the public in health

research

• Drive faster translation of scientific discoveries into tangible benefits for

patients

• Maximise the research potential of the NHS to contribute to the

economic growth of the country through the life science industry

• Act as sound custodians of public money for the public good

SETTING STRATEGICDIRECTIONS AND PRIORITIES

NIHR Advisory BoardThe NIHR Advisory Board’s role is to advise the NIHR on improving the culture and performance of health and social care in supporting, conducting and hosting research. The NIHR Advisory Board includes NHS chief executives, representatives of key bodies in health and social care as well as leaders of academic organisations and representatives from patient-focused organisations.

NIHR Strategy BoardThe NIHR Strategy Board advises on the strategic issues relating to the management of NIHR and the implementation of NIHR’s strategic plans, ensuring the NIHR acts as one entity and communicates effectively both externally and internally. The Board includes directors of the NIHR coordinating centres, programmes and infrastructure, and the senior management team of the Research and Development Directorate (RDD) at the Department of Health.

3NIHR ANNUAL REPORT 2015/16

STRUCTUREThe NIHR manages its health research activities through four main work

strands:

• Research: commissioning and funding research

• Infrastructure: providing the facilities and people for a thriving

research environment

• Faculty: supporting the individuals carrying out and leading research

• Systems: promoting faster, easier clinical research through unified,

streamlined and simple systems for managing ethical research and its

outputs.

The diagram opposite shows the NIHR health research system, which has

the interests of patients and the public at its heart.

The main work strands of the NIHR are managed by the following NIHR

Coordinating Centres:

• Infrastructure is managed by the NIHR Clinical Research Network

Coordinating Centre (CRNCC) and the Central Commissioning

Facility (CCF)

• Research is managed by the NIHR Evaluation, Studies and Trials

Coordinating Centre (NETSCC) and the CCF

• Faculty is managed by the NIHR Trainees Coordinating Centre (TCC)

• INVOLVE is managed by the INVOLVE Coordinating Centre.

Information management and research management systems are managed

by the CRNCC and through a cooperative venture between the work

strands and the Department of Health.

Investigators and Senior Investigators

Trainees Associates

Clinical Research Network

Clinical Research Facilities Centres and Units

Research Projects and Programmes

Research Schools

FACULTY

INFRASTRUCTURE RESEARCH

SYSTEMS

Research Information Systems

Faster easier clinical research

UNIVERSITIES

NHS TRUSTS

PATIENTS AND

PUBLIC

4NIHR ANNUAL REPORT 2015/16

The Government Spending Review 2015

In the Spending Review, published on 25 November 2015, the Government

demonstrated its continued strong support for research by protecting

funding for the NIHR through the Department of Health (DH) R&D

budget. This was in recognition of the crucial role that health and care

research plays in improving the health of patients and the public and in

underpinning economic growth through the life science industries. RDD was

also allocated an additional budget of £449.5 million to commission global

health research through the NIHR.

Professor Chris Whitty CB FMedSci appointed as Chief Scientific

Adviser for the Department of Health

On 2 December 2015, Professor Chris Whitty was appointed as the Chief

Scientific Adviser at the DH with responsibility for the Science, Research and

Evidence portfolio and overall strategic responsibility for the NIHR, following

the decision by the Chief Medical Officer, Professor Dame Sally C Davies, to

step back from the leadership of the NIHR and the R&D Directorate at the

Department of Health.

Best Research for Best Health: 10 years since publication

25 January 2016 marked the tenth anniversary of the publication of Best

Research for Best Health (BRfBH), the Government’s health research strategy

that created the NIHR in April 2006. BRfBH set out the national goals for

research and development and demonstrated a commitment to creating a

vibrant national research environment that contributed to the health and

wealth of England.

BRfBH has been endorsed by subsequent governments and remains the

enduring research strategy for health and care research in England.

The NIHR at 10

On 13 January 2016, and in recognition that the NIHR would reach its tenth

anniversary in April, then Minister for Life Sciences, George Freeman MP,

hosted the first NIHR Parliamentary Day in Portcullis House, Westminster.

Dr Russell Hamilton CBE

Dr Russell Hamilton CBE, Director of R&D at DH, retired at the end of

March 2016. Russell had worked closely alongside Dame Sally Davies for

many years, conceptualising the government’s health research strategy,

Best Research for Best Health, and subsequently creating, developing and

building the NIHR into the internationally recognised organisation it is today.

STRATEGICNEWS2015/16

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HRA Approval

Health Research Authority (HRA) Approval replaced the NIHR’s Coordinated

System for gaining NHS Permission (CSP) in May 2015. HRA Approval brings

together the assessment of governance and legal compliance, undertaken

by dedicated HRA staff, with the independent Research Ethics Committee

opinion provided through the UK Health Departments’ Research Ethics

Service. It replaces the need for local checks of legal compliance and related

matters by each participating organisation in England.

Genomics England Ltd

Genomics England Ltd (GEL) has been allocated up to £50 million a year

from NIHR’s budget to deliver the world-leading 100,000 Genomes Project.

Key progress in 2015/16 included completing around 8,000 whole genome

sequences and putting in place a complex informatics infrastructure to

allow the NHS to capture medical data. GEL has started to provide reports

back to the NHS to enable the diagnoses of rare disease and inform

patient treatment. It has also established the Genomics England Clinical

Interpretation Partnership bringing together 2,500+ researchers and

clinicians to analyse the unique dataset of genomic and medical data which

the project is building to enable new scientific and medical breakthroughs.

STRATEGIC NEWS 2015/16

6NIHR ANNUAL REPORT 2015/16

NIHR Dissemination Centre

We contracted the Wessex Institute at the University of Southampton, in

collaboration with Bazian, to provide a new NIHR Dissemination Centre

from 1 April 2015. The Centre critically appraises the latest research findings

from both the NIHR and other health research organisations to identify the

most reliable, relevant and significant findings. It summarises and interprets

the evidence to help NHS clinicians, commissioners and patients make the

best decisions about which treatments and practices are most effective and

provide the best use of resources.

The Centre also offers a series of other dissemination activities including

events, webinars, podcasts and blogs.

INVOLVE

We awarded a new INVOLVE Coordinating Centre contract, worth £3.2

million over four years from 1 February 2016, to the Wessex Institute.

INVOLVE will deliver its services at national, regional and local levels through

a new partnership with our Research Design Service, building on strong

foundations of providing central coordination for our patient and public

involvement, participation and engagement agenda. INVOLVE is charged

with delivering the NIHR’s commitments to public involvement, participation

and engagement set out in Going the Extra Mile.

The Leadership Support and Development Programme

A new three-year contract for the NIHR Leadership Support and

Development Programme commenced in August 2015 and is being

delivered by Ashridge Consulting Ltd. The Programme focuses on improving

the quality of research leadership in clinical and applied health and social

care research. The programme’s workstreams are designed to support the

development of our Research Leaders and Trainees, NHS R&D Managers

and our strategic collaborations.

Fourth Blood and Transplant Research Unit

Our Blood and Transplant Research Units (BTRUs) support the future

needs of donors, patients and NHS Blood and Transplant (NHSBT). The

first three NIHR BTRUs were contracted in March 2015. The fourth, based

at the University of Bristol, contracted in October 2015 and representing

£3 million of the NIHR’s investment, will carry out research to support the

development of new blood products for treatment of patients with rare

blood types and those needing regular transfusions.

SIGNIFICANTCHANGES2015/16

CONTRACTS

7NIHR ANNUAL REPORT 2015/16

SIGNIF ICANT CHANGES 2015/16

A strategic alliance between our Clinical Research Network and

global biopharmaceutical company, Pfizer

The alliance, announced in June 2015, is the first time an entire national

research network has been invited to participate in Pfizer’s INSPIRE

programme highlighting the important role our Clinical Research Network

performs in delivering commercial clinical research in the UK. Through

INSPIRE, Pfizer and the Clinical Research Network will share expert

knowledge and experience of medicines research to help bring more clinical

trials to the UK and to help deliver the best results for patients in the NHS.

The Biomedical Research Centre competition

On 15 December 2015, the Chancellor announced a new, open

competition for NIHR Biomedical Research Centres (BRCs), worth around

£800 million over five years from April 2017. NHS/University partnerships in

England with very substantial portfolios of world-class biomedical research

across either a range of clinical or research areas, or in a specific clinical or

research area, were eligible to apply.

A competition to renew and refresh NIHR funding and designation

for Clinical Research Facilities

In February 2016, we announced a competition to renew and refresh NIHR

funding and designation for Clinical Research Facilities (CRFs), to cover

the period from April 2017 to March 2022. These facilities allow specialist

clinical researchers and support staff from universities and NHS Trusts to

work together on patient-orientated commercial and non-commercial

experimental medicine studies to speed up the translation of scientific

advances. All NHS organisations in England with an established CRF,

including those with existing contracts for NIHR CRFs, were eligible to apply.

The Quinquennial Review of the Experimental Cancer Medicine

Centres Network

In February 2016, Cancer Research UK and the Departments of Health for

Scotland, Wales and Northern Ireland, announced the Quinquennial Review

of the Network of Experimental Cancer Medicine Centres (ECMCs) for the

period covering April 2017 to March 2022. The Network brings together

world-class expertise in each of its Centres, and provides industry partners

with the opportunity to collaborate with academia to obtain access to

cutting-edge, early-stage innovation.

ANNOUNCEMENTS

8NIHR ANNUAL REPORT 2015/16

The Surgical Technology Evaluation Portal

Launched in May 2015, the Surgery Technology Evaluation Portal (STEP)

is the result of a partnership between our Office for Clinical Research

Infrastructure (NOCRI) and the Royal College of Surgeons. STEP provides

surgical technology developers with rapid access to a wide network of

research-active surgical clinicians and three projects are already underway.

The Integrated Clinical Academic Programme

A new Integrated Clinical Academic Programme for non-medical healthcare

professionals was established in 2015. Funded by Health Education

England and managed through our Trainees Coordinating Centre, it made

34 personal awards during its first year; comprising 24 Clinical Doctoral

Fellowships, 7 Clinical Lecturers and 3 Senior Clinical Lecturers. Ten

Higher Education Institutions were awarded Masters in Clinical Research

Studentships per year for 3 years from 2015/16.

Patient Research Ambassador Initiative

Through our Clinical Research Network, we launched the Patient Research

Ambassador Initiative in January 2016. In collaboration with a range of NHS

stakeholders, including NHS England, research ambassadors will encourage

local NHS service providers to help patients find out more about taking part

in research studies.

S IGNIF ICANT CHANGES 2015/16

9NIHR ANNUAL REPORT 2015/16

In 2015/16, we appointed:

Professor Dave Jones as Dean

for Faculty Trainees on 1 July

2015. The Dean is an important

role which fosters the next

generation of health researchers,

ensuring the quality of training

programmes and development of

career pathways for healthcare

professionals. Professor Jones

took over from Professor Jim

Neilson who was the inaugural

post-holder in 2008 and who has

now retired.

Professor Hywel Williams

succeeded Professor Tom Walley

as the NIHR Health Technology

Assessment (HTA) Programme

Director in the autumn of 2015.

Professor Alan Jackson was

appointed as the first NIHR

Director of Nutrition Research in

February 2016.

Dr William Van’t Hoff was

appointed as Clinical Director for

NHS Engagement at our Clinical

Research Network in February

2016.

Professor Julia Brown, Director

of the Clinical Trials Unit at

the University of Leeds was

appointed as Deputy Chair of the

HTA Clinical Evaluation and Trials

board.

Professor David Crossman was

appointed as the next Chair of

the Efficacy and Mechanism

Evaluation (EME) Funding Board,

succeeding Professor Rajesh

Thakker who stepped down in

Spring 2016.

APPOINTMENTS

10FOREWORD

Poorer ratings of care from commercial out-of-hours care providers

In the first study of its kind, a team funded through our Programme Grants

for Applied Research at the University of Exeter Medical School analysed

results from more than 80,000 patients who had responded to the English

General Practice Patient Survey, and who had used an out-of-hours service

in the past six months.

Published online in the BMJ, the study compared commercial providers and

NHS providers with not-for-profit providers. Commercial providers scored

lowest overall, and NHS providers scored highest by a small margin. This

finding was evident even after controlling for factors including ethnicity,

gender, age, deprivation, parent status and the ability to take time away

from work to use daytime GP services.

Bronchiolitis trial wins BMJ Award for research paper of the year

Bronchiolitis is a viral infection of the lung that most often affects infants.

It can be treated with oxygen, but it was not known when it is best to

start using oxygen or how much to use. Dr Steve Cunningham of the

Department of Child Life and Health at Edinburgh University and colleagues

led the HTA-funded study which compared two recommended oxygen

levels (low/90% and normal/94%), finding there was no clinical difference

between the two. However, children in the lower oxygen group starting

feeding sooner and returned home earlier. It was also £290 cheaper to treat

infants in the lower oxygen group.

The research was published in the Lancet in September 2016 and it won

‘research paper of the year’ at the 2016 BMJ Awards. This award recognises

original UK research published in the past year with the greatest potential

to significantly improve health and healthcare.

Switching off streetlights at night does not increase traffic accidents

and crime

Research funded through our Public Health Research Programme and

published in the Journal of Epidemiology and Community Health in July

2015 demonstrated that local authorities could save energy costs and

reduce carbon emissions by reducing street lighting at night without there

being an increase in traffic accidents or crime.

Led by investigator, Dr Phil Edwards of the London School of Hygiene &

Tropical Medicine, the research team analysed data from 62 local authorities

across England and Wales who had implemented a range of reduced street

light strategies. The researchers looked at the type of street lighting in

place in each local authority area and then examined the numbers of traffic

accidents and reported crime that had taken place in those areas finding no

evidence of an association between reduced street lighting and night-time

collisions. An estimated £300 million is spent every year on street lights in

the UK and by carefully assessing risks, street lighting can be reduced by

local authorities without an increase in car crashes and crime.

SOMEIMPACTFULRESEARCH STUDIES

11NIHR ANNUAL REPORT 2015/16

More people are dying in hospices

The proportion of people dying in hospices in England has nearly doubled

since 1993, but the gap in hospice deaths between people living in the least

and most deprived areas appears to be growing.

Published in the journal Palliative Medicine, and funded through our Health

Services and Delivery Research Programme and our Collaboration for

Leadership in Applied Health Research and Care, the study examined all

hospice deaths in England over a 20-year period, including almost 450,000

deaths from 1993-2012. It investigated the relationship between dying in

a hospice and factors such as age, diagnosis and socio-economic position.

This is the first study to use whole-population data to examine how hospice

deaths have changed over time, and the factors related to hospice death.

Chemical markers in urine provide clues to how obesity causes

disease

Scientists at Imperial College London, supported by our Health Protection

Research Unit on Health Impact of Environmental Hazard and Imperial

Biomedical Research Centre have identified chemical markers in urine

associated with body mass, providing insights into how obesity causes

disease.

Being overweight or obese is associated with higher risk of heart disease,

stroke, diabetes and cancer, but the mechanisms connecting body fat and

disease are not well understood. The study has shown that obesity has a

‘metabolic signature’ detectable in urine samples, pointing to processes

that could be targeted to mitigate its effects on health. The findings are

published in Science Translational Medicine.

Prototype device provides a voice for throat cancer patients

A prototype device that provides realistic sounding speech to patients

whose voice box has been removed as part of treatment for throat cancer

and other conditions has been developed with funding from our Invention

for Innovation (i4i) Programme. The approach involves attaching magnetic

implants to the lips and tongue which detect motion and translate it into

computer-generated speech. This technology could benefit up to 6,000

patients in the UK, providing better quality of speech and, compared to

existing technology such as implanted speech valves, potentially reduce

costs to the NHS of up to £10 million per year.

SOME IMPACTFUL RESEARCH STUDIES

12NIHR ANNUAL REPORT 2015/16

A new, simple postural manoeuvre can stop an abnormally fast

heart rate

A trial funded by our Research for Patient Benefit programme showed

that a simple postural change to the Valsalva manoeuvre improves the

effectiveness of this cheap, non-invasive means of treating supraventricular

tachycardia – an abnormally fast heart rate of over 100 beats per minute.

Tested in ten hospital emergency departments in England and published in

the Lancet in 2015, the technique found that laying people flat and raising

their legs was three times more effective at bringing their heart rhythm

back to normal than in the usual semi-reclining position. The findings add

to existing guidance and have the potential to reduce the need for more

interventional treatments, such as intravenous adenosine, which may have

unpleasant side effects, save resources and improve patient satisfaction.

A new approach to delivering stop smoking services

A six month study funded through our Programme Grants for Applied

Research, of a mobile, drop in, stop smoking service operating from various

locations in Nottingham was found to be effective in reaching smokers

who had not previously accessed stop smoking services. This service also

appeared to be an effective way to trigger action in smokers without prior

intentions to cease smoking. This mobile service was similar in cost per user

to the standard stop smoking service.

The study was published in the BMJ in January 2016.

DNA technology to diagnose cases of tuberculosis (TB) faster

Whole Genome Sequencing was applied by researchers at Oxford’s John

Radcliffe Hospital to detect the presence of TB in patients presenting with

the condition. The technology could also determine whether the strain

detected was resistant to commonly used antibiotics within one week.

This is up to eight times faster than detection through traditional diagnosis

methods.

Funded by the Health Innovation Challenge Fund and supported by our

Oxford Biomedical Research Centre (BRC), the innovative technology also

proved more cost effective, at an average cost of £481 per positive case,

compared to £517 per case using current technologies. The results of this

trial have implications for TB prevention in the UK. The new technique

will be adopted by Public Health England (PHE) and is expected to reduce

transmission of TB.

SOME IMPACTFUL RESEARCH STUDIES

13NIHR ANNUAL REPORT 2015/16

‘Bionic eye’ restores the ability to read

In January 2016, surgeons at the Oxford Eye Hospital at the John Radcliffe

Hospital implanted a tiny electronic chip, measuring 3x3mm², at the back of

a blind woman’s retina to replace damaged photoreceptors allowing her to

read the time for the first time in more than five years.

Funded by our i4i Programme in partnership with Retina Implant AG and

our Oxford BRC, the ‘bionic eye’ as a treatment for retinitis pigmentosa

has been tested in Oxford since 2012 and during this time the hospital has

worked in close partnership to develop the technology with the hope that it

will one day be ready for use across the NHS.

New imaging scans track down persistent cancer cells

The HTA-funded research showed that innovative scanning-led surveillance

can identify the need for, and guidance of, neck dissection, to remove

remaining cancer cells. The study, led by Professor Janet Dunn, from

Warwick Clinical Trials Unit and published in March 2016 in the New

England Journal of Medicine, used advanced imaging to identify cancer

cells still present after treatment of head and neck cancer. Previous

guidelines meant that all head and neck cancer patients had to undergo

neck dissection surgery, a three-hour operation with considerable morbidity

and up to a one week hospital stay, because there was no reliable way to

identify which patients still had remaining cancer cells.

When compared with neck dissection, the PET-CT guided surveillance

saved almost £1.5 thousand per person for the NHS and is a much more

acceptable intervention for patients. With tens of thousands of cases each

year across the world, significant savings could be redistributed into other

therapies.

Valve implants show positive results for patients with emphysema

A study investigating the use of valves placed in the lungs of patients

with emphysema has concluded that the treatment produces significant

improvements in lung function and ability to do light exercise, and provides

a less invasive alternative to surgery to remove the affected part of the lung.

Emphysema is a condition of the lungs that causes breathlessness, limiting

ability to do even light exercise and affecting quality of life. The study,

funded by our Efficacy and Mechanism Programme, an MRC and NIHR

partnership, involved 50 patients with severe emphysema. Half had valves

placed to shut off airflow to the impaired part of their lung and half did

not. The valves stopped air entering this portion of the lung, where it would

otherwise become trapped, allowing the remaining healthier sections of the

lung to function more efficiently.

Findings from the study, published in The Lancet, showed that after three

months lung function and exercise tolerance had improved significantly in

the group receiving the valve and had the potential to limit the need for

lung reduction surgery.

SOME IMPACTFUL RESEARCH STUDIES

14NIHR ANNUAL REPORT 2015/16

Patient and public participation, involvement and engagement in

our work

Throughout the year, more than 605,000 people participated in clinical

research studies through our Clinical Research Network.

Over and above supporting patients to take part in studies, we are

committed to patient and public involvement (PPI), in all aspects of our

research as it leads to research that is relevant, better designed, with clearer

outcomes, and the uptake of new evidence is faster.

As well as significant PPI in our research centres and facilities in the NHS,

during 2015/16, our research funding programmes worked with:

• 144 people in developing funding applications

• 84 individuals reviewing our pre-commissioning briefs

• 547 people reviewing applications for our funding

• 108 patients and the public as members of our Boards and Panels.

INVOLVE

INVOLVE is our national advisory group on public involvement in research,

and is one of the few Government funded programmes of its kind in the

world. During 2015/16, INVOLVE:

• responded to over 285 complex enquiries to support researchers to deliver effective public involvement in research

• had nearly 600,000 unique visitors to the INVOLVE website with the ‘Briefing notes for researchers’ downloaded over 100,000 times

• advertised 100 opportunities for public involvement through the People in Research website

• gained over 1,000 followers to @NIHRINVOLVE Twitter account, bringing the total to more than 4,100 followers.

During the year and under the direction of Simon Denegri, our National

Director for Patient and Public involvement in Research, INVOLVE ran

our strategic review of how successful we have been in achieving public

involvement across all our activities. The evidence submitted came from

patients, members of the public, the voluntary sector, researchers, medical

research charities and industry through written, oral and video formats.

There were also dedicated events and focus groups offering the opportunity

to comment on the current state of involvement and priorities for the

future. The review resulted in the report Going the Extra Mile, published in

March 2016, with its recommendations subsequently endorsed by Professor

Dame Sally C Davies, Chief Medical Officer.

STATISTICS ANDINFORMATION:1 APRIL 2015 – 31 MARCH 2016

15NIHR ANNUAL REPORT 2015/16

Spotlight Campaigns

Each year, we run a number of ‘spotlight campaigns’ to help engage the

public in different aspects of research. In 2015/16 these included:

• A nation-wide ‘Big Challenge’ campaign in January, promoting obesity research in the four key areas of surgery, lifestyle, mental health and brain imaging. A radio day with the Chief Executive of our Clinical Research Network received coverage by 10 major news networks including Sky News which has a reach of 31 million people. Online coverage included Pharma News online, Wallstreet online and Yahoo Finance and our NIHR webpage received 410 unique visits plus a further 847 viewings of a series of video case studies.

• In February, and to coincide with Children’s Mental Health Week, we created a series of online resources for children and young people to help them find out about mental health research and how it can help them. Seven national charities asked for their logos and websites to be linked to the campaign which received 1,492 visits leading to 351 viewings of four videos. 7,155 people joined the campaign’s Facebook page, making it our most popular page ever recorded.

• Our fourth annual ‘OK to ask’ campaign in May to raise public awareness of NHS research and encourage patients to ask their doctor about clinical research they might take part in. Our Local Clinical Research Networks ran open days, mock research trials, information stands, touring buses and social media campaigns in their area. Over 100,000 leaflets, badges and other materials were distributed during the campaign and our #NIHRoktoask hashtag reached nearly a million people.

STATISTICS AND INFORMATION: 1 APRIL 2015 – 31 MARCH 2016

16NIHR ANNUAL REPORT 2015/16

We contribute to growth in many ways by creating a research environment

that supports the nation’s international competitiveness. We attract,

develop and retain a highly skilled health research workforce, provide the

clinical evidence to help the NHS and public sector to make efficient use of

resources and provide the research evidence that contributes to establishing

a healthier workforce and wider population.

The contribution we make to the economy through attracting investment

by the UK and global life sciences industry, and through collaboration

with charities, is vital. Our infrastructure in the NHS and integrated health

research system contributes to driving the nation’s economic growth by

supporting the studies of national and global life sciences industry, charities

and other health research funders.

During the year, our research infrastructure:

• generated £150 million of industry funding

• supported 3,176 industry collaborative and contract research studies

• recruited 14 first global and 13 first European patients into commercial contract studies, a strong indicator that the UK is a highly competitive environment in terms of rapid study set-up

• published 10,169 peer reviewed publications, demonstrating a 4-fold increase since 2009/10 financial year

• reported a total of 1,021 individual research partnerships and collaborations with SMEs.

During this year, NIHR BRCs and BRUs alone:

• saw £171 million NIHR investment leverage industry funding of £130 million

• undertook 1,604 contract and collaborative industry studies

• had 174 patent applications filed and 45 applications granted

• generated £75.6 million from exploiting intellectual property

• had 15 spin-off companies established, winning private sector investment from the UK and abroad.

In addition, the BRCs and BRUs supported:

• 602 studies funded by UK research councils leveraging £285 million

• 1,742 studies funded by charities leveraging £402 million.

CONTRIBUTING TO ECONOMIC GROWTH

Our world-class infrastructure in the NHS comprises

Biomedical Research Centres (BRCs), Biomedical Research

Units (BRUs), Clinical Research Facilities (CRFs), Diagnostic

Evidence Co-operatives (DECs), Healthcare Technology

Co-operatives (HTCs), Collaborations for Leadership in

Applied Health Research and Care (CLAHRCs) and Patient

Safety Translational Research Centres (PSTRCs) as well as our

Clinical Research Network (CRN).

17NIHR ANNUAL REPORT 2015/16

Our Clinical Research Network (CRN) supports the life-sciences industry

to deliver their research programmes in the NHS. During the year, the

Network:

• recruited nearly 35,000 people to take part in commercial contracts studies across 74% of NHS Trusts

• had 650 new commercial contract studies added to their portfolio of supported research.

A study, published in the science journal PLOS ONE in February 2016,

showed for the first time that research active Trusts deliver better health

outcomes for their patients. Each year, our Network publishes the Research

Activity Table, which highlights the extent of research activity across the

NHS in England. This year, 100% of NHS Trusts recruited patients to

studies on the CRN portfolio. In addition, 42% of GP practices recruited

participants to CRN supported studies.

CONTRIBUTING TO ECONOMIC GROWTH

18NIHR ANNUAL REPORT 2015/16

The Government’s 2020 Dementia Challenge is galvanising dementia and

neurodegeneration research, with NIHR playing a central role in ensuring

the success of this strategy. In March 2016, the Department of Health

published the 2020 Dementia Challenge Implementation Plan, which sets

out how funding partners will make this the best country in the world for

dementia research in terms of research funding, research capacity, delivering

new treatments and improving lives.

Funding

NIHR funding for dementia research has continued to grow, reaching £37

million, representing a further year of steady growth from £24 million in

2012/13, and being a major contribution to meeting the commitment to

maintain Government funding at £60 million a year.

Translational Research Collaboration-Dementia (TRC-D)

A significant part of NIHR’s contribution is TRC-D, operating across NIHR’s

Biomedical Research Centres and Biomedical Research Units. TRC-D

pulls discoveries from basic science into benefits for patients, and offers

partners in the life science industries a single point of access to research

infrastructure for developing new treatments. TRC-D is a partner of

Dementias Platform UK and will partner with the new national Dementia

Research Institute.

Capacity

To develop capacity in care research NIHR’s Collaborations for Leadership

in Applied Health and Care Research operate a doctoral research training

programme for nurses and allied health professionals. This delivered training

and national meetings to a cohort of 13 Dementia Care trainees, to be

research leaders of the future able to translate findings into benefits for

people with dementia and their carers.

NIHR infrastructure also contributes to training and capacity development,

with 68 trainees in dementia research in TRC-D, and 48 research

trainees in NIHR’s other Biomedical Research Units and Centres

whose research is related to dementia and neurodegeneration.

DEMENTIARESEARCH

19NIHR ANNUAL REPORT 2015/16

Participation

During the year, a total of 34,812 participants were recruited into 274

dementias and neurodegenerative studies, providing a 62% increase

on the previous year. Studies included a wide range of research, from

drug trials and interviews to online brain-training studies.

An increasing proportion of participants were recruited to studies

directly through Join Dementia Research (JDR), a partnership between

Alzheimer’s Research UK, the Alzheimer’s Society, Alzheimer Scotland and

the NIHR. The service enables people to register their interest in taking part

in research and, this year, 11,033 new registrants signed up.

As of 31 March 2016, there were:

• 22,510 people registered on JDR

• 135 NHS, university and commercial research organisations successfully recruited via JDR.

ENRICH

ENRICH is our Research Ready Care Home Network. It brings together care

home staff, residents and researchers to facilitate the design, delivery of,

and enable participation in, research, coordinated by our National Director

for Dementia Research. There are now 1,500 care homes in the Network

and, this year, residents have taken part in 65 dementia-related studies.

The ENRICH toolkit is considered a unique resource and referenced by

almost all researchers working with care home residents or in the sector.

During 2015/16 the site received 8,872 visits from 6,666 unique visitors

and of those 2,287 returned to the site multiple times.

DEMENTIA RESEARCH

20NIHR ANNUAL REPORT 2015/16

OURRESEARCHPROGRAMMES

Our research evaluates the effectiveness and impact of healthcare

treatments, finds new ways of preventing, identifying and treating ill health,

and makes this evidence widely available to ensure decisions about health

and social care are informed by the best possible evidence.

Throughout the year we funded a total of 224 projects across our range of

research funding programmes. This breaks down by programme into:

In addition to this we had 372 studies running in our Health Protection

Research Units and another 15 studies in our Blood and Transplant

Research Units.

Setting research priorities through our Priority Setting Partnerships

The James Lind Alliance (JLA) Priority Setting Partnerships (PSPs) agree

research priorities that are of importance to patients and clinicians nationally

and internationally. There were 36 active PSPs over the year, including 16

new partnerships, six of which are taking place internationally.

During the year, eight PSPs published their top research priorities. These

covered:

• Stillbirth

• Anaesthesia and Perioperative Care

• Surgery for Common Shoulder Complaints

• Mild to Moderate Hearing Loss

• Hair Loss

• Cavernoma (a cluster of abnormal blood vessels, usually found in the brain and spinal cord)

• Depression

• Kidney Transplant

A new JLA website launched in September 2015 to showcase the work

of the JLA PSPs and is now the comprehensive repository of PSP and JLA

activity and place of reference for PSP outputs.

21

53

5

Efficacy and Mechanism Evaluation

32Health Service andDelivery Research

51Health Technology

Assessment

23Public Health

Research

Research for Patient Benefit

Programme Development Grants

20

Invention for Innovation

19Programme Grants for Applied Research

21NIHR ANNUAL REPORT 2015/16

OUR RESEARCH PROGRAMMES

Horizon Scanning

Our Horizon Scanning Research & Intelligence Centre (HSRIC) supplies

information to policy and decision-makers within the NHS and research

funders about emerging health technologies that may have a significant

impact on patients or the provision of health services in the near future.

This year, the HSRIC increased the number of new and emerging

technologies identified by one third, including more than a 50% increase

in the number of outputs relating to pharmaceuticals and advanced

therapies, and an overall increase to 495, up from 346 the previous year,

comprising:

• 37 MedTech alerts

• 11 MedTech and drugs intelligence reports

• 301 filtration forms

• 146 technology briefings.

Technology Assessment Reviews

Each year we commission Technology Assessment Reviews (TARs) to provide

the independent advice that helps inform health policy decisions in England

and NICE guidance. This year, 63 active TARs were being monitored and

52 TARs were completed.

PROSPERO

PROSPERO, our international Prospective Register of Systematic Reviews,

contains registration details of ongoing systematic reviews. Submissions to

PROSPERO doubled in the past year with approximately 600 added

per month. The register now contains nearly 11,000 records of reviews

being undertaken in 102 different countries and territories around the

world.

Themed Calls

Each year the NIHR invites experts to submit funding applications on specific

themes that require research in order to inform NHS decisions.

This year, we:

• announced the outcome of the themed call for research proposals in Long Term Conditions in Children and Young People with a total investment of £21 million in 35 new studies, including seven Fellowship awards

• awarded two Fellowships for the Older People with Multi-morbidities themed call

• received 58 applications for the Prevention and Treatment of Obesity themed call with three shortlisted by the Health Services and Delivery Research programme, five by the Health Technology Assessment Programme and one by the Public Health Research Programme. The final funding decisions are expected in the Autumn of 2016.

22NIHR ANNUAL REPORT 2015/16

PUBLICATIONS

We support the principle of open access to increase the potential for quality

research to be widely disseminated and freely accessed and expect findings

from all our funded research to be published in an appropriate form.

This year there were 13,282 publications arising from our funding, including

many in high impact journals such as the Lancet, the BMJ and the New

England Journal of Medicine.

Journals Library

Our Journals Library provides full publication and open access to an

extensive body of our research. Between April 2015 and March 2016 we

published 172 issues alongside plain English summaries. There were:

• 102 issues in volume 19 of Health Technology Assessment, the highest number ever published in one year

• 46 issues in volume 3 of Health Services and Delivery Research

• 6 issues in volume 3 of Programme Grants for Applied Research

• 15 issues in volume 3 of Public Health Research

• 6 issues in volume 2 of Efficacy and Mechanism Evaluation.

The Journals Library website received over 280,000 visits, of which 74%

were unique, and there were nearly 500,000 views.

In addition, final reports of completed research undertaken by the three

NIHR Research Schools – Primary Care, Public Health and Social Care – are

now also published on the Journals Library website including 31 School for

Primary Care Research outputs, 11 School for Public Health Research

outputs and 5 School for Social Care Research outputs.

Dissemination Centre

Our new Dissemination Centre critically appraises the latest research

findings from both the NIHR and other health research organisations to

identify the most reliable, relevant and significant findings. It summarises

and interprets the evidence to help NHS clinicians, commissioners and

patients make the best decisions about which treatments and practices are

most effective and provide the best use of resources. During 2015/16 the

Centre:

• published 130 NIHR Signals – accessible summaries of recent research from the NIHR and other funders

• attracted over 1,000 new email subscribers

• gained more than 3,000 new Twitter followers

• published three Highlights on managing obesity in men, cognitive therapies for depression and supporting carers of people with dementia

• launched two Themed Reviews – in-depth reports looking at NIHR research into end of life care and ambulance services, with events held in London and Sheffield.

23NIHR ANNUAL REPORT 2015/16

SUPPORTINGOUR RESEARCHCOMMUNITY

Research Design Service

Our Research Design Service (RDS) provides expert advice and support for

researchers developing funding applications, helping researchers design

high quality studies using the most appropriate approach to answer the

research question. This year the RDS:

• supported 2,784 new projects comprising:

o 620 outline submissions

o 1,035 full/one stage applications

o 226 shortlisted outline submissions

• resulting in 401 funded applications.

Leadership Support and Development

Our new three-year NIHR Leadership Support and Development Programme

launched with two cohorts of Trainees – 40 in total, and two

cohorts of Leaders – 51 in total, recruited to their bespoke programmes

commencing during 2015/16. In addition, two cohorts of R&D Managers

and Directors with a total of 101 participants, representing 50 NHS

Trusts, commenced their programme. Several Strategic Operational Priority

areas were also supported by the programme during the year.

24NIHR ANNUAL REPORT 2015/16

Our research community is the largest networked body of experts and

their teams in the world. The diverse groups of people working together to

improve the health and wealth of the nation through research are known as

the NIHR Faculty.

NIHR Research Trainees

We support the training of future health and social care researchers through

a range of national career development programmes as well as through

training in the NIHR infrastructure which has a remit to build research

capacity.

During the year, we managed 2,031 active trainees in awards across our

Trainees Programmes and appointed four new Research Professorships.

We award Research Professorships to outstanding research leaders in the

early part of their careers to strengthen future leadership in research.

Our Trainees Programmes awarded:

• 65 Fellowships, of which 33 were Doctoral, 11 were Post-Doctoral, 8 were Career Development Fellows, 2 were Senior Research Fellowships, 6 were Clinical Trials Fellowships and 5 were Knowledge Mobilisation Research Fellowships

• 250 Academic Clinical Fellowships and 100 Clinical Lecturer positions with 6 Clinician Scientist awards and 10 In-Practice Fellowships

• 10 Research Methods Fellowships and Internships and 5 Systematic Review Fellowships were awarded in the programme’s second year

• Renewed funding for 48 Masters Studentships in Medical Statistics with 5 Higher Education Institutions (HEIs) being awarded 2-4 studentships each year for 3 years and the Masters Studentships in Economics of Health continued to be provided by four HEIs.

In addition, we supported a total of 3,678 trainees based in our NHS

infrastructure, of which 2,765 were PhD students.

OURFACULTY ANDTRAINEES

25NIHR ANNUAL REPORT 2015/16

FINANCIALSUMMARY

26NIHR ANNUAL REPORT 2015/16

FINANCIAL SUMMARY

NIHR funding for 2015/16Area Spend (£ million) 2015/16

RESEARCH PROGRAMMES

Health Technology Assessment 73.5

Health Services Delivery & Research (previously HSR & SDO) 20.9

Programme Grants for Applied Research 33.7

Research for Patient Benefit 17.8

Invention for Innovation 13.9

Public Health Research 10.1

Systematic Reviews (Cochrane and TARs) 14.0

Horizon Scanning 1.8

Schools: Primary Care, Public Health and Social Care Research 14.1

Methodology 1.0

INVOLVE 0.7

Health Innovation Challenge Fund 7.0

Health Protection Units (funded by NIHR from 1 April 2010) 10.4

Other (including legacy programmes and management not attributed to specific programmes) 29.0

RESEARCH PROGRAMMES TOTAL 247.9

27FINANCIAL SUMMARY

Area Spend (£ million) 2015/16

INFRASTRUCTURE

Research Capability Funding 91.0

Clinical Research Network 304.0

Biomedical Research Centres 137.1

Biomedical Research Units 26.3

Patient Safety Translational Research Centres 3.0

Clinical Research Facilities 22.7

Experimental Cancer Medicine Centres 3.4

Collaborations for Leadership in Applied Health Research and Care 26.5

Excess Treatment Costs 1.3

Research Design Service 10.6

BioResource 2.3

Translational Research Collaborations 4.8

Healthcare Technology Co-operatives 1.7

Diagnostic Evidence Co-operatives 1.0

MRC/NIHR National Phenome Centre 1.0

Other (including Athena Swan and dementia) 1.2

INFRASTRUCTURE TOTAL 637.9

FACULTY TRAINEES

Integrated Academic Training (including academic clinical fellowships, lectureships and

clinician scientist awards) 59.5

Fellowships (including legacy training awards) 20.1

Senior Investigators 3.8

Other (including management and clinical academics) 10.7

FACULTY TOTAL 94.1

F INANCIAL SUMMARY

28FINANCIAL SUMMARY

Area Spend (£ million) 2015/16

SYSTEMS

Information systems that enable research 7.8

SYSTEMS TOTAL 7.8

TOTAL REVENUE SPEND 987.7

OTHER

NIHR contribution to Genomics England 50.0

TOTAL NIHR SPEND 1,037.7

F INANCIAL SUMMARY

29FINANCIAL SUMMARY

NIHRANNUALREPORT2015/16